Question 1

Which works better for weight loss, Ozempic or Contrave?

Accepted Answer

Ozempic recorded ~10-15% TBWL off-label at 1-2 mg (Wegovy is the indicated semaglutide; STEP-1 ~14.9%); Contrave recorded ~6.1% body weight vs 1.3% placebo at 56 weeks (COR-I). ⚠ These come from separate trials with different protocols and populations, so the gap between two numbers from two studies is weaker evidence than it looks. No head-to-head trial of this pair is on record here.

Question 2

Are Ozempic and Contrave the same drug?

Accepted Answer

No. Ozempic is semaglutide and Contrave is naltrexone-bupropion — different molecules, and they work differently: GLP-1 receptor agonist (semaglutide) against Opioid antagonist + aminoketone antidepressant (naltrexone 8 mg + bupropion 90 mg). Results with one do not predict results with the other.

Question 3

Is Ozempic or Contrave cheaper?

Accepted Answer

On the manufacturers' own cash pricing: Ozempic at ~$599-$999/month brand list; NovoCare savings for T2D patients with coverage, Contrave at ~$99/month via Currave/Currax direct-pay program. ⚠ That is the list-price comparison, and it is not what most people pay. What you actually pay depends on whether your plan covers it, which formulary tier it sits in, and whether you have met your deductible — and for many people the honest comparison is between an insured copay and a cash-pay compounded alternative rather than between these two figures.

Question 4

Does either one have better cardiovascular evidence?

Accepted Answer

Ozempic does. Ozempic: 26% reduction in major CV events in SUSTAIN-6 (T2D + high CV risk). Contrave: No proven CV mortality benefit; LIGHT trial terminated early in 2015. This matters more than it first appears — a drug with a completed outcomes trial has evidence about events that matter, not only about weight, and that is often what decides coverage.

Question 5

Which has worse side effects, Ozempic or Contrave?

Accepted Answer

The most common adverse event reported was Nausea ~15-20%, vomiting, constipation, diarrhea for Ozempic and Nausea ~30%, constipation, headache, insomnia, dry mouth for Contrave. ⚠ Rates come from separate trial populations and are not a like-for-like comparison. In practice how fast the dose is escalated affects tolerability at least as much as which drug it is, which is one reason a slower titration is worth asking for.

Question 6

How is each one taken?

Accepted Answer

Ozempic: Weekly subcutaneous injection; 0.25 -> 0.5 -> 1 -> 2 mg. Contrave: Oral tablet, twice daily; titrated to 32 mg/360 mg total daily dose over 4 weeks. Worth weighing honestly against your own habits — the best drug for you is partly the one you will still be taking in eight months, and a dosing routine that does not fit a life gets abandoned.

Question 7

What does a compounded version of each actually cost?

Accepted Answer

Across the 556 sellers in this register, the cheapest standing monthly cash prices we hold are semaglutide from $79 a month. ⛔ A compounded preparation is not the approved product: no agency has reviewed that specific preparation for safety, effectiveness or manufacturing quality, and the legal ground under compounding these molecules narrowed once the shortages closed. The price gap is real and so is the difference in oversight.

Question 8

Can I switch from Ozempic to Contrave?

Accepted Answer

Yes, with a prescriber. Expect to re-titrate from the bottom of the new drug's ladder rather than starting where you left off: these are different molecules and tolerance to one does not transfer to the other. Both the old drug's washout and the new drug's schedule apply.

Question 9

Which one should I ask for?

Accepted Answer

That is a prescriber's call, and anyone answering it from a table is guessing. What a page like this can do is tell you what the trials measured, what the manufacturers charge, and where the evidence is still missing, so the conversation starts from the record rather than from an advertisement.

Field	Ozempic	Contrave
FDA-approved indication	Type 2 diabetes (2017); CV risk reduction in T2D with CVD	Chronic weight management with BMI >=30 or >=27 + comorbidity (2014)
Drug class / mechanism	GLP-1 receptor agonist (semaglutide)	Opioid antagonist + aminoketone antidepressant (naltrexone 8 mg + bupropion 90 mg)
Route and dosing	Weekly subcutaneous injection; 0.25 -> 0.5 -> 1 -> 2 mg	Oral tablet, twice daily; titrated to 32 mg/360 mg total daily dose over 4 weeks
Average weight loss at ~1 year (label dose)	~10-15% TBWL off-label at 1-2 mg (Wegovy is the indicated semaglutide; STEP-1 ~14.9%)	~6.1% body weight vs 1.3% placebo at 56 weeks (COR-I)
Cash price (US, 2026)	~$599-$999/month brand list; NovoCare savings for T2D patients with coverage	~$99/month via Currave/Currax direct-pay program
Cardiovascular outcomes	26% reduction in major CV events in SUSTAIN-6 (T2D + high CV risk)	No proven CV mortality benefit; LIGHT trial terminated early in 2015
Most common side effects	Nausea ~15-20%, vomiting, constipation, diarrhea	Nausea ~30%, constipation, headache, insomnia, dry mouth
Boxed warnings / major safety	Boxed warning: thyroid C-cell tumors (rodent data); contraindicated with personal/family MTC or MEN 2	Boxed warning: suicidal thoughts/behaviors in young adults (bupropion); seizure risk; contraindicated in uncontrolled hypertension, seizure disorder, eating disorders, chronic opioid use
Use for weight loss without diabetes	Off-label only; Wegovy is the FDA-approved semaglutide for obesity	On-label for adults with BMI >=30, or BMI >=27 with weight-related comorbidity

Ozempic vs Contrave: Off-Label Injection, On-Label Pill

The verdict

Side-by-side comparison

What each one costs in the compounded market

Frequently asked questions